Failure of Routine HIV-1 Tests in a Case Involving Transmission With Preseroconversion Blood Components During the Infectious Window Period

Ling, Ai Ee

doi:10.1001/jama.284.2.210

Cited by 93 publications

(77 citation statements)

References 20 publications

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“…NAT screening was implemented in the United States and other countries in 1999 using MP screening in which 16 or more donor specimens are pooled prior to testing (8,42). Prior to the use of MP-NAT, HIV was transmitted via window-stage donations at significant rates (5,22). Although very rarely, HIV has been transmitted by window period blood donations that were determined to have Յ150 vRNA copies/ml even after the adoption of MP-NAT (9,11,35,36).…”

Section: Discussionmentioning

confidence: 99%

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

Zhong

Stone

Piatak

et al. 2009

J Virol

116

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To define the ratio of simian immunodeficiency virus (SIV) RNA molecules to infectious virions in plasma, a ramp-up-stage plasma pool was made from the earliest viral RNA (vRNA)-positive plasma samples (collected approximately 7 days after inoculation) from seven macaques, and a set-point-stage plasma pool was made from plasma samples collected 10 to 16 weeks after peak viremia from seven macaques; vRNA levels in these plasma pools were determined, and serial 10-fold dilutions containing 1 to 1,500 vRNA copies/ml were made. Intravenous (i.v.) inoculation of a 1-ml aliquot of diluted ramp-up-stage plasma containing 20 vRNA copies infected 2 of 2 rhesus macaques, while for the set-point-stage plasma, i.v. inoculation with 1,500 vRNA copies was needed to transmit infection. Further, when the heat-inactivated set-point-stage plasma pool was mixed with ramp-up-stage virions, infection of inoculated macaques was blocked. Notably, 2 of 2 animals inoculated with 85 ml of a pre-ramp-up plasma pool containing <3 SIV RNA copies/ml developed SIV infections characterized by high levels of viral replication, demonstrating that "vRNA-negative" plasma collected from macaques in the pre-ramp-up stage is infectious. Furthermore, there is a high ratio of infectious virions to total virions in ramp-up-stage plasma (between 1:1 and 1:10) and a lower ratio in set-point-stage plasma (between 1:75 and 1:750). Heat-inactivated chronic-stage plasma can "neutralize" the highly infectious ramp-up-stage virions. These findings have implications for the understanding of the natural history of SIV and human immunodeficiency virus infection and transmission.

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Section: Discussionmentioning

confidence: 99%

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

Zhong

Stone

Piatak

et al. 2009

J Virol

116

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“…Long term seronegative yet infected state has been reported, especially once more sensitive methods for detecting the virus were developed (Imagawa et al 1989;Ensoli et al 1990;Gupta et al 1992). Incomplete detection of potentially infectious blood units (Ling et al 2000), and other donated organs (e.g. sperm, kidney, bone marrow) can transmit HIV infection to the recipients.…”

Section: Infection At the Seronegative Wp Is Infectiousmentioning

confidence: 99%

“…In Singapore, it has been reported that a blood transfusion was the source of an HIV infection. The authors state that the blood donation and transfusion of blood components occurred in Singapore, where blood donation testing for HIV is similar to US protocols, including anti-HIV-1 and anti-HIV-2 EIAs and an HIV-1 p24 antigen EIA (Ling et al 2000). In another report two infections were caused by a blood donation in 2002 (Phelps et al 2004).…”

Section: Infectious Blood and Blood Products From Donors At The Seronmentioning

confidence: 99%

The HIV Seronegative Window Period: Diagnostic Challenges and Solutions

Jehuda-Cohen¹

2011

Recent Translational Research in HIV/AIDS

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“…1 Nucleic acid detection methods for HIV and hepatitis C (HCV) have reduced the window period for infectious risk, but may not eliminate transfusion-associated HIV 2 or HCV infections; 3 fatal bacterial infections caused by transfusion of platelet concentrates continue to be reported. 4 To improve the safety of platelet and plasma transfusion, a nucleic acid-targeted photochemical treatment (PCT) using the psoralen compound amotosalen HCl (S-59) and longwavelength ultraviolet A (UVA) light was developed to inactivate viruses, bacteria, and protozoa that may contaminate platelet and plasma components.…”

Section: Introductionmentioning

confidence: 99%

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Rhenen

Gulliksson

Cazenave

et al. 2002

Blood

290

444

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A nucleic acid-targeted photochemical treatment (PCT) using amotosalen HCl (S-59) and ultraviolet A (UVA) light was developed to inactivate viruses, bacteria, protozoa, and leukocytes in platelet components. We conducted a controlled, randomized, double-blinded trial in thrombocytopenic patients requiring repeated platelet transfusions for up to 56 days of support to evaluate the therapeutic efficacy and safety of platelet components prepared with the buffy coat method using this pathogen inactivation process. A total of 103 patients received one or more transfusions of either PCT test (311 transfusions) or conventional reference (256 transfusions) pooled, leukoreduced platelet components stored for up to 5 days before transfusion. More than 50% of the PCT platelet components were stored for 4 to 5 days prior to transfusion. The mean 1-hour corrected count increment for up to the first 8 test and reference transfusions was not statistically significantly different between treatment groups (13 100 ؎ 5400 vs 14 900 ؎ 6200, P ‫؍‬ .11). By longitudinal regression analysis for all transfusions, equal doses of test and reference components did not differ significantly with respect to the 1-hour (95% confidence interval [CI], ؊3.1 to 6.1 ؋ 10 9 / L, P ‫؍‬ .53) and 24-hour (95% CI, ؊1.3 to 6.5 ؋ 10 9 /L, P ‫؍‬ .19) posttransfusion platelet count. Platelet transfusion dose, pretransfusion storage duration, and patient size were significant covariates (P < .001) for posttransfusion platelet counts. Clinical hemostasis, hemorrhagic adverse events, and overall adverse events were not different between the treatment groups. Platelet components prepared with PCT offer the potential to further improve the safety of platelet transfusion using technology compatible with current methods to prepare buffy coat platelet components. (Blood. 2003;101: 2426-2433)

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Failure of Routine HIV-1 Tests in a Case Involving Transmission With Preseroconversion Blood Components During the Infectious Window Period

Cited by 93 publications

References 20 publications

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

The HIV Seronegative Window Period: Diagnostic Challenges and Solutions

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

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